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Article
Comparison of Rate of Caesarean Section between Governmatal and Private Hospitals in Baghdad City

Authors: Majida Mustafa Al-Naimy --- Batool A. Gh. Yassin --- Hassan H. B. AL-Kazzaz
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 2 Pages: 288-295
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

BACKGROUND: Rising rates of caesarean section (CS) is a worldwide concern. OBJECTIVE: Evaluating rate and indications of CS at both public and private hospital in Baghdad. MATERIALS AND METHODS:A review of all (1354) records of CS patients during January 2009 (552 public, 802 private hospitals) was performed. RESULTS: Rate of CS was higher in private (59.2%) hospital and among mothers aged 25-29 years. Youngerpatients and elective CS were higher among private patients, emergency CS was higher amongpublic patients. Most CS was performed in term pregnancy, longitudinal lie in both. The mostfrequent indications were pervious scar (previous CS) and fetal distress in both sectors,malpresentation in the public and failure to progress in the private hospital. Maternal request wasfound only in the private.CONCLUSION: According to the accepted rates of CS adopted by the World Health Organization (WHO) (5% 15%);CSrateisstillhighinbothsectors,establishing audit committee, good training with secondopinion strategy are vital to reduce i

Keywords

caesarean section --- private


Article
MATERNAL AND FETAL OUTCOMES IN EMERGENCY VERSUS ELECTIVE TWO OR MORE PREVIOUS CAESAREAN DELIVERIES

Authors: Yousif A AL-Raheem يوسف عبد الرحيم --- Thikra Najim ذكرى نجم --- Faris A Rasheed فارس رشيد
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2010 Volume: 6 Issue: 1 Pages: 108-117
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Women with previous two or more caesarean deliveries are usually managed by elective cesarean section to avoid the possible risks of labor. Objective: To compare the relative risks of maternal and fetal outcomes in emergency versus elective previous two or more caesarean deliveriesDesign: Randomized prospective clinical studySetting: Al-Elweya Maternity Teaching Hospital, from 1st of March to 31st of September 2008.Methods: The study groups, those who had previous two or more caesarean deliveries, were included from the hospital admissions. The 1st group (102 women) presented in labor and was managed by caesarean delivery as soon as it was possible. The second group (78 women) was admitted for elective cesarean delivery.The main maternal outcomes were intra operative complications, including hysterectomy, scar dehiscence, bladder injuries, uterine and internal iliac arteries ligation, and blood transfusion. Postoperative maternal outcomes were severe morbidity including bleeding, fever, urinary tract infection, blood transfusion, the need to Intensive Care Unit admission and readmission. The fetal outcomes measures were Apgar score at one and five minutes, respiratory distress syndrome (RDS), admission to the neonatal intensive care unit and fetal loss up to hospital discharge.Results: Both groups were comparable in demographic, social and past obstetric history characteristics. Intra operative complications showed significant difference in bowel adhesions (RR 0.35, 95% CI 0.14- 0.88), and blood transfusion (RR 0.51, 95% CI 0.28-0.94). There was statistical significant difference in the mobilization time 7.2 hours and 9.3 hours in emergency and elective groups respectively (p= 0.0009), also in feeding time, it was shorter after emergency caesarean section (P=0.0224), and in the hospital stay 24.6 and 32.6 hours respectively (p=0.0001). There was no statistical difference in post operative complications. Fetal outcomes showed no statistical significant difference in fetal loss, respiratory distress and readmission.Conclusion: Women with previous two or more caesarean deliveries can wait until starting labor for doing cesarean delivery without increasing risks to the mother and fetus.


Article
The effect of pre-operative intravenous Cyklokapron on the amount of blood loss during and after caesarean section for anemic patients At Al Yarmouk teaching hospital in Baghdad.

Authors: Hind Abdul Khaliq --- Ban Hadi Hameed
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2016 Volume: 15 Issue: 3 Pages: 23-27
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Back ground: caesarean section carries significant morbidity and mortality over vaginal delivery. Anemia with hemorrhagic complications add significantly for this morbidity and mortality. Aim of the study: to assess the effectiveness of Cyklokapron in reducing the intra-operative blood loss at time of caesarean section and postpartum hemorrhage in anemic patients and to evaluate its safety when used prophylactically. Patients and method: A hundred pregnant women aged 19 - 41 years with term gestation were recruited in this randomized, case control, prospective therapeutic trial, which was conducted for a period of one year at Al Yarmouk teaching hospital Baghdad Iraq, the participants were admitted for caesarean section. They were divided randomly into two groups; the study group 50 patients received intravenous Cyklokapron pre-operatively and a control group matched for the indication of caesarean section, the intra-operative, post-operative blood loss and hematocrit were evaluated and compared for both groups. Results: The intra-operative blood loss was measured in both groups, the total loss was significantly lower in the study group (170.12 ± 68.4 ml) compared to the control group (420.39 ± 130.6 ml) as P value was 0.0001 Concerning the post-operative blood loss, it was comparable in both groups and blood transfusion was required for two patients in the control group because of severe anemia (hemoglobin less than 8 gmdl) with no transfusion in the study group and this difference was not significant statistically. The mean reduction in hematocrit was significantly lower in the study group compared to control group (1.52 ± 0.81%) versus (2.58±0.85%) respectively and P value was less than 0.05 Conclusion and recommendations: The current study revealed that Cyklokapron is significantly effective in reducing blood loss at time of caesarean section. We recommend further studies with higher doses and more patients to evaluate its effect in reducing the intra-operative loss and preventing postpartum hemorrhage.


Article
Pattern of knowledge and attitude of women in reproductive age group about Caesarean Section in Basrah city
نمط معرفة وموقف النساء في سن الإنجاب عن العملية القيصرية في مدينة البصرة

Author: Rasha A. Al-Timari
Journal: The Medical Journal of Basrah University المجلة الطبية لجامعة البصرة ISSN: 02530759 Year: 2018 Volume: 36 Issue: 1 Pages: 1-6
Publisher: Basrah University جامعة البصرة

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Abstract

Background: Caesarean section is increasing as a means of delivery. A decision on this choice need to be joint among doctors, women and others. An appropriate decision will be facilitated with good knowledge of women about this operation. Objectives: To assess the knowledge and attitude of women in the reproductive age about Caesarean Section.Methods: This is a descriptive cross sectional study carried out in Basrah city among women in the reproductive age group who visited two primary health centers(Al-Razi and Al-Seef centers). The study involved 242 women with age range from 15-45 years, Results: History of one or more Caesarean Section was reported by 35.5%. The results of study showed that all the women involved in this study heard about Caesarean Section and a good number of them had an idea about the effect of Caesarean Section on the number of children, the possibility of vaginal delivery after first Caesarean Section and about some chronic diseases (hypertension and diabetes) which might increase the prospect of Caesarean Section. Majority of participants preferred normal vaginal delivery because of rapid recovery and less complication than Caesarean Section.Conclusions: Caesarean section is a prevailing practice in Basrah city. Women had good knowledge about it but in general they prefer normal vaginal delivery.

الخلفية: تتزايد نسب الولادة بالعملية القيصرية واللجوء اليها يتطلب قرارا مشتركا بين الطبيب وإلام وربما آخرين ومعرفة المرأة الجيدة يسهل اتخاذ القرار المناسب.الطرائق: أجريت هذه الدراسة الوصفية المقطعية في مدينة البصرة على النساء اللواتي في سن الإنجاب في اثنين من المراكز الصحية الأولية(مركز الرازي ومركز السيف) وذلك لتقييم مدى معرفتهم وموقفهم من الولادات القيصرية. هذه الدراسة شملت 242 امرأة من عمر 15-45 سنة.الهدف: تقييم معارف ومواقف النساء في سن الإنجاب حول العملية القيصرية.النتائج: كان 35،5% من النساء قد خضعن لعملية قيصرية واحدة أو أكثر. أظهرت نتائج الدراسة ان جميع النساء المشمولات في الدراسة قد سمعوا مسبقا بالولادات القيصرية وان عدد كبير منهم لديه معرفة بتأثير العمليات في تحديد عدد الأطفال وبإمكانية الولادة الطبيعية بعد العملية القيصرية الأولى وكان لديهم معرفة ببعض الأمراض المزمنة التي قد تزيد من احتمال إجراء العملية القيصرية. معظم النساء في هذه الدراسة يفضلن الولادة الطبيعية بسبب سرعة الشفاء وقلة المضاعفات مقارنة بالولادة القيصرية. ويمكن الاستنتاج بان إجراء العمليات القيصرية في مدينة البصرة شائع وعموما يمتلك النساء معرفة جيدة عنها لكن معظمهم يفضلون الولادة الطبيعية.


Article
Second Delivery in Women with a Previous Elective Caesarean Section for Breech Presentation in first Pregnancy
الولادة الثانية في الحوامل اللاتي أجريت لهن عملية قيصرية باردة في الحمل الأول بسبب جيئة مقعدية

Author: Ibtissam Y Al-Safar د. ابتسام يوسف الصفار
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2006 Volume: 19 Issue: 2 Pages: 204-210
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract:Objective: To evaluate the mode of next delivery and fetal presentation for women who had an elective caesarean section for breech presentation when primigravidae. Design: Retrospective- follow up cohort study.Setting: Al- Yarmouk Teaching Hospital/department of Obstetrics and Gynaecology.Methods: 333 women who presented for delivery of their second baby at > 34 weeks of gestation during the period Jan 2002-Jan 2004 with a history of an elective caesarean section when primigravidae: 189 of them for a breech presentation and 144 for other indications with a cephalic presentation, were studied to evaluate the fetal presentation and the mode of their second delivery. Results: Of 189 women who had an elective caesarean section with a breech presentation when primigravidae , 16 (8.5%) had a breech presentation at the time of elective caesarean section for their next baby compared with only 3 (2.1%) in women who had an elective caesarean section with a cephalic presentation when primigravidae ( RR 4.06 [ 95% CI 1.2 to 13.67 ] ) . The overall repeat section rate was 41.3% (n = 78) in women with a previous breech presentation (n = 189), compared with 59% (n = 85) in women with a previous cephalic presentation (n = 144) (RR 0.70 [95% CI 0.56 to o.86]). The vaginal birth rate for those women allowed to labour was 80.4% (n=111) if the presentation previously was breech (n = 138) compared with 64.8% (n = 59) if the presentation previously was cephalic (n=91) (RR 1.24 [95% CI 1.04 to 1.47]). Conclusions: Women who had an elective caesarean section for a breech presentation when primigravidae were shown to have 8.5% chance of having an elective caesarean section for a breech presentation in their second pregnancy. The incidence of repeat caesarean section for their second baby was 41.3%, and of those allowed to labour, 80.4% achieved a vaginal delivery compared with 59% and 64.8% respectively for women who had an elective caesarean section with a cephalic presentation in their first pregnancy. These results will help in counseling primigravida women with a breech presentation intended to be delivered by an elective caesarean section," aiming at reduction of perinatal morbidity and mortality", about the good chances of a successful vaginal birth of their second baby with a cephalic presentation and also provides more information about mode of delivery in the presence of previous one caesarean section. Key words: previous caesarean section, breech, second delivery

هدف الدراسة :الحصول على معلومات حول طريقة الولادة الثانية في الحوامل اللاتي أجريت لهن عملية قيصرية باردة في الحمل الأول بسبب جيئة مقعدية .مكان إجراء الدراسة : مستشفى اليرموك التعليمي/ قسم النسائية و التوليد للفترة من كانون الثاني 2002 إلى كانون الثاني 2004 .نوع الدراسة : دراسة استرجاعية جماعية مع متابعة .طريقة الدراسة: تم إدخال 333 امرأة للولادة في حملهن الثاني في الدراسة . 189 منهن أجريت لهن عملية قيصرية باردة في حملهن الأول بسبب جيئة مقعدية و 144 منهن أجريت لهن عملية قيصرية باردة في حملهن الأول لأسباب أخرى . ثم تمت مقارنة طريقة الولادة للطفل الثاني في المجموعتين .النتائج :- تكررت الجيئة المقعدية في 16 ( 8.5% ) من الحوامل اللاتي أجريت لهن عملية قيصرية باردة في الحمل الأول بسبب جيئة مقعدية مقارنة مع 3 ( 2.1% ) في الحوامل مع قيصرية باردة أولى لأسباب أخرى (الخطر النسبي كان 4.06 , حدود 95 % ثقة من1,2 الى 13,67). - كان المجموع الكلي لإجراء عملية قيصرية ثانية 78 من 189 ( 41.3% ) في الحوامل مع قيصرية أولى بسبب جيئة مقعدية ( المجموعة الأولى ) مقارنة مع 85 من144 ( 59 % ) في الحوامل مع قيصرية أولى لأسباب أخرى ( الخطر النسبي كان 0.7 , حدود 95 % ثقة من 0.56 الى 0.86 ) - نسبة نجاح الولادة المهبلية في الحوامل اللواتي تم السماح لهن لخوض ولادة كان كالأتي: 111 من 138 (80.4 % ) في المجموعة الأولى مقارنة مع 59 من 91( 64.8 %) في المجموعة الثانية ( الخطر النسبي كان 1.24 , حدود 95% ثقة من 1.04 الى 1.47 ).الاستنتاج : هذه النسبة العالية لحدوث ولادة مهبلية في المجموعة الأولى تمكن الطبيب المسؤول من زيادة فهم المرأة الحامل مع جيئة مقعدية بان إجراء عملية قيصرية أولى لهذا السببان يحتم بالضرورة إجراء عملية قيصرية في الحمل الثاني و مايليه و لكنه يقلل من حدوث المضاعفات المتوقعة في الولادة المهبلية مع هذه الجيئة .تسهم هذه الدراسة أيضا في إلقاء المزيد من الضوء على إعطاء محاولة للولادة المهبلية بوجود عملية قيصرية سابقة واحدة .


Article
Prevalence of placenta accreta in Diyala governorate during 2010-2012 years
انتشار أكرتا المشيمة في محافظة ديالى خلال السنوات 2010-2012

Author: Sawsan Talib Salman،Ali Hassan Mohammed،Nadhim Ghazal Noaman،Huda Khaleel Ibrahim
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2013 Volume: 19 Issue: 2 Pages: 286-295
Publisher: Tikrit University جامعة تكريت

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Abstract

Background:- Although the incidence of placenta accreta is rare but it has a serious complications which may end with hysterectomy so early diagnosis is important to prevent this complications. Objective:- this study aim to assess the problem of the obstetrician about the magnitude of this serious health problem. Patient and methods:- this study was conducted in Al-Batoul teaching hospital (in the center of Diyala governorate by studying the patient records as a retrospective study, study the record from June 2010 during July 2012 including all patients with placenta accreta. Results:- Showed the rate of placenta accreta among all deliveries was (0.12) and (0.14), (0.78) among normal vaginal deliveries and caesarean sections respectively and more among those women with previous two pregnancies and above (83.33%), regarding blood groups it showed (56.66%) among O blood group while it was (23.3%), (16.66%), (3.33%) among B, A and AB respectively. The association with placenta previa was (40%) with grade I while it was (20%) with grade II, (16.66%) grade III and (13.3%) grade IV. It was (16.66%) among women with history of curettage and (76.66%) among those with history of pelvic inflammatory diseases . Regarding the management (56.66%) was managed by packing and repair during caesarean section and (43%) were ended by hysterectomy. Conclusion:- placenta accreta was more common previous caesarean sections and pelvic inflammatory diseases management may be ended by hysterectomy. Recommendation:- Early diagnosis is important to minimize complications.

الخلفية : - على الرغم من أن حدوث المشيمة أكرتا أمر نادر الحدوث لكنه لا يملك المضاعفات الخطيرة التي قد تنتهي مع استئصال الرحم حتى التشخيص المبكر مهم لمنع هذه المضاعفات. الهدف : - هذا الهدف دراسة لتقييم مشكلة التوليد حول حجم هذه المشكلة الصحية الخطيرة . المريض وطرق : - أجريت هذه الدراسة في البتول تعليم المستشفى ( في وسط محافظة ديالى من خلال دراسة سجلات المرضى كدراسة بأثر رجعي ، ودراسة السجل من يونيو 2010 خلال يوليو 2012 بما في ذلك جميع المرضى الذين يعانون من المشيمة أكرتا النتائج: - أظهرت أن معدل المشيمة أكرتا بين جميع الولادات ( 0.12) و ( 0.14) ، ( 0.78 ) بين الولادات المهبلية الطبيعية و القيصرية على التوالي و أكثر بين هؤلاء النساء مع الحمل السابق و اثنين أعلاه ( 83.33 ٪ ) ، فيما فصائل الدم فإنه أظهرت ( 56.66 ٪ ) بين فصيلة الدم O بينما كانت ( 23.3 ٪ ) ، ( 16.66 ٪ ) ، ( 3.33 ٪ ) بين B ، A و AB على التوالي. وكانت العلاقة مع المشيمة المنزاحة ( 40 ٪ ) مع الصف الأول في حين كان ( 20 ٪ ) مع الصف الثاني ، ( 16.66 ٪ ) الصف الثالث و ( 13.3 ٪ ) الصف الرابع ، وكانت ( 16.66 ٪ ) بين النساء مع التاريخ من كشط و ( 76.66 ٪ ) من بين أولئك الذين لديهم تاريخ من أمراض التهابات الحوض. وفيما يتعلق وقد تمكنت إدارة ( 56.66 ٪ ) من خلال التعبئة والإصلاح خلال عملية قيصرية و ( 43 ٪ ) و انتهت استئصال الرحم. الاستنتاج : - كان أكرتا المشيمة أكثر شيوعا العمليات القيصرية السابقة، و أمراض التهاب الحوض الإدارة قد انتهت من قبل استئصال الرحم. التوصية : - التشخيص المبكر مهم للحد من المضاعفات.


Article
Vaginal birth after caesarean section with less than two years delivery interval
الولادة المهبلية بعد الولادة القيصرية مع فترة الولادة أقل من عامين

Authors: Raida Mala Fatah --- Ghada Alsakkal
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2015 Volume: 19 Issue: 3 Pages: 1063-1068
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: A dramatic rise in caesarean deliveries has been occurring over the past three decades. The old myth of “once a caesarean always a caesarean” is no longer acceptable as this increases maternal morbidity. The aim of this study was to evaluate the safety and success of vaginal birth after caesarean section performed before less than two years. Methods: A cross-sectional study was conducted in the Maternity Teaching Hospital in Erbil, Iraq from May to October 2012. Ninety two patients meeting the inclusion criteria were included in this study and followed up during their labour. Patients monitored for vaginal bleeding, scar tenderness and tachycardia. Results: Of 92 patients with single lower segment caesarean section that underwent trial of labour; 52 (56.5%) patients had successful trial of labour and 40 (43.5%) had a repeated caesarean section. Factors found to be significantly affecting trial of labour were parity (P = 0.01), inter-delivery interval (P <0.001) and cervical dilatation (P = 0.015). Conclusion: Vaginal birth after caesarean section is a reasonable choice for women with single lower segment caesarean section with good monitoring of mother and baby during labour. Short inter-delivery period does not preclude vaginal delivery in a woman with single lower segment caesarean section providing that there is no contraindication for vaginal delivery.


Article
Uterine rupture with alive twins in a Holstein Frisian cow: a case report
تمزق الرحم بأجنة توأم حية في بقرة هولشتاين فريزيان: تقرير حالة

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Abstract

This report describes a case of uterine rupture in a cow with alive twins, and its treatment.

يصف هذا التقرير حالة تمزق الرحم بأجنة توأم حية في بقرة لأول مرة وطريقة التعامل معها.


Article
Knowledge and Preference of Mothers Delivering at ALKadhumyia Teaching Hospital Regarding Caesarean Section and Normal Vaginal Delivery

Authors: Huda Adnan Habib --- Maysaloun Muhammed Abdulla --- Selwa Elias Yacoub
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 4 Pages: 512-518
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT :BACKGROUND:Caesarean section rates are progressively rising in many parts of the world. One suggested reason isincreasing requests by women for caesarean section in the absence of clear medical indications.OBJECTIVE:To determined the medical and non medical reasons behind the caesarean section. To identify themothers preference to the mode of delivary and reasons behind this preference.MATERIALS AND METHODS:Across sectional study of 480 mothers was interviewed .The data was collected using a questionnaireform includes information under two main headings: 1) Information related to the mother; theseinclude demographic and some obstetrical information, obstetrical 2) Knowledge of mothersregarding reasons behind their caesarean section.3) Information related to mother preference.RESULTS:The majority of mothers 317(66%) were delivered by Caesarean section ,the majority of Caesareansection mothers (41%) were of (36-45) years of age , (47.3%) completed primary education., ( 89%)of them reported medical reasons behind their Caeserean section, (25.9%) of mothers with medicalreasons reported a history of Caeserean section as the main medical reason .Regarding the nonmedical reasons the majority of mothers (45.7%) reported Fear of vaginal delivery as the main nonmedical reasons . The majority 384(80%) of mothers prefer NVD while only (20%) reported theirpreference to C-sectionCONCLUSION:The caesarean section rate was high, history of Caeserean section were the main medical reasonbehind caesarean section , fear of vaginal delivary was the main non medicval reason behindcaesarean section. Majority of mothers prefer NVD than C-section


Article
Knowledge and Preference of Mothers Delivering at ALKadhumyia Teaching Hospital Regarding Caesarean Section and Normal Vaginal Delivery

Authors: Huda Adnan Habib --- Maysaloun Muhammed Abdulla --- Selwa Elias Yacoub
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 4 Pages: 512-518
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT :BACKGROUND:Caesarean section rates are progressively rising in many parts of the world. One suggested reason isincreasing requests by women for caesarean section in the absence of clear medical indications.OBJECTIVE:To determined the medical and non medical reasons behind the caesarean section. To identify themothers preference to the mode of delivary and reasons behind this preference.MATERIALS AND METHODS:Across sectional study of 480 mothers was interviewed .The data was collected using a questionnaireform includes information under two main headings: 1) Information related to the mother; theseinclude demographic and some obstetrical information, obstetrical 2) Knowledge of mothersregarding reasons behind their caesarean section.3) Information related to mother preference.RESULTS:The majority of mothers 317(66%) were delivered by Caesarean section ,the majority of Caesareansection mothers (41%) were of (36-45) years of age , (47.3%) completed primary education., ( 89%)of them reported medical reasons behind their Caeserean section, (25.9%) of mothers with medicalreasons reported a history of Caeserean section as the main medical reason .Regarding the nonmedical reasons the majority of mothers (45.7%) reported Fear of vaginal delivery as the main nonmedical reasons . The majority 384(80%) of mothers prefer NVD while only (20%) reported theirpreference to C-sectionCONCLUSION:The caesarean section rate was high, history of Caeserean section were the main medical reasonbehind caesarean section , fear of vaginal delivary was the main non medicval reason behindcaesarean section. Majority of mothers prefer NVD than C-section

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